The Role of Gut Microbiome in Obesity and Weight Management: A Review of Current Evidence and Future Directions

ABSTRACT Obesity has become an emerging challenge all over the world. In 2022, one in eight people was living with obesity. It is most common in adults and children. It is due to an imbalance between energy consumption and utilization. However, the human gut microbiome regulates energy metabolism, a complex ecosystem of microorganisms residing in the gastrointestinal tract, which stimulates hormone production, produces various metabolites, and interacts with brain responses involved in maintaining energy balance in the body. Dysbiosis, characterized by an imbalance in microbial composition, has been linked to increased energy harvesting, impaired bile acid metabolism, chronic low‐grade inflammation, impaired appetite regulation, and excessive intake, ultimately leading to obesity. The primary focus of this review is to discuss the current understanding of the roles of diet, exercise, pharmacological agents, and surgery in shaping gut microbial communities and host physiology. Dietary interventions, such as the use of probiotics, prebiotics, high‐fiber diets, ketogenic diets, and intermittent fasting, modulate microbial metabolites like short‐chain fatty acids, which play a crucial role in regulating energy balance and inflammation, thereby contributing to the prevention of weight gain. Physical activity induces positive changes in gut microbiota, enhancing metabolic adaptability and supporting immune system regulation. Pharmacological treatments, especially anti‐obesity and anti‐diabetic drugs, have both direct and microbiota‐mediated effects on weight and glucose metabolism. Similarly, surgery leads to significant changes in gut microbiota, which play a role in long‐term enhancements in metabolic health. So, this review aims to discuss various weight management approaches targeting the gut microbiome, drawing on current studies. However, these interventions require further investigation for their effectiveness.